Montana's proposal to increase oversight is part of a national trend by states to ensure nonprofit hospitals act as charitable organizations as they claim tax-exempt status. Montana is poised to become the latest state to increase scrutiny of how its nonprofit hospitals deliver community benefits in exchange for their tax-exempt status. Under proposed rules, the Montana Department of Public Health and Human Services plans to collect data on nonprofit hospitals' charitable acts, such as discounting prices, providing health education, or conducting free screenings.
Montana officials expect to adopt the new rules in August, but state officials have yet to set standards for exactly what constitutes acceptable giving or how much hospitals must do. The proposal comes some four years after a state audit found shortcomings in the health department’s oversight. The rules largely mirror federal requirements that national health policy analysts said have yet to lead to any meaningful enforcement.
"What is being proposed in Montana doesn’t really move the needle," said Kevin Barnett, a researcher with the California-based nonprofit Public Health Institute who has studied hospital community benefits for decades. "It kicks the can down the road to say 'we’ll consider this another day.'" State officials would now be paying more attention, he said, but the impact depends on what they do with the information.
Montana's plan is part of a national trend by states to try to cover federal e.